Clinical Laboratory Analysis Research Articles

ANÁLISE DAS PRÁTICAS DE DESCARTE DE MATERIAIS BIOLÓGICOS EM LABORATÓRIOS

Introduction: The correct disposal of biological materials is important for the health of the whole population, thus avoiding soil contamination and preventing accidents with sharp-perforated materials. The Agência Nacional de Vigilância Sanitária – (ANVISA) has established rules for an appropriate disposal of the biological waste such as incineration, grounding and radiation. These rules are applied to laboratories, hospitals, clinics, doctors' offices and other health facilities. Objective: To analyze the disposal of biological waste by the laboratories of the city of Montes Claros, Minas Gerais. Methodology: A field study that presents a quantitative, descriptive and cross-sectional analysis with a population of four clinical analysis laboratories and a company responsible for the final waste disposal. Questionnaires were applied for a better analysis of the data. Results: The results indicate that the laboratories participating in the research are aware of ANVISA standards and they are concerned about their collaborators and the population, making sure that they are not putting them at risk. Conclusion: The training of professionals is necessary to avoid accidents with perforating materials.

Urethral obstruction in a ram with a periurethral abscess: clinical findings, diagnostic imaging and pathology

BackgroundUrethral obstruction is a common and life-threatening condition in male small ruminants.Case presentationThis case report describes a 3-year old 103 kg Zwartbles breeding ram, presented with the complaint of straining, suspected to have an urethral obstruction. The work-up included clinical examination, laboratory analyses, ultrasound imaging, (contrast) radiography and urine examination. At presentation, blood analysis revealed a respiratory alkalosis, hyperkalaemia and mild azotaemia. On transabdominal ultrasound an enlarged bladder (diameter 11 cm) and free fluid surrounding the right kidney were observed. Treatment of the animal included tube cystostomy, intravenous perfusion, antimicrobial treatment, ammonium chloride and NSAIDs. No indications for urolithiasis were found on ultrasound, radiography, or urine examination. As no improvement was seen despite 16 days of therapy, a contrast radiograph of the urinary tract, as well as reproductive exam were conducted. Positive anterograde urethrogram showed a contrast filled cavitary lesion at the caudal aspect of the pelvic urethra. The reproductive ultrasonography revealed the same large urethral distention or abscess compressing the pelvic urethra, as well as severe testicular degeneration in both testis. The results of the contrast radiograph and the reproductive exam lead to the decision to euthanize the animal, as the animal would not be capable of breeding. Computed tomography was performed post-mortem, which showed close relation between the cavitary lesion and the left bulbourethral gland. Pathology revealed a lymphoplasmacytic to suppurative infection at the level of the urogenital tract, chronic interstitial nephritis and a perirenal to cortical abscess of the right kidney as well as a periurethral abscess. As for the reproductive system, multifocal interstitial inflammatory infiltrates were seen on the entire system. Marked fibrosis and atrophy was seen at the level of the testes and both epididymides.ConclusionsA periurethral abscess should be included in the differential diagnosis for an urethral obstruction in small ruminants. The extensive medical imaging, together with the ante-mortem and post-mortem findings, makes this a good reference case for diagnosticians confronted with urethral problems in a ram.

Clinical characteristics and outcomes of patients presenting with acute coronary syndromes and suspected plaque erosion

Abstract Background Plaque erosion (PE) is the second most common pathology of acute coronary events after plaque rupture. PE is characterized by endothelial denudation and formation of neutrophil extracellular traps. Patients with PE may have a different prognosis as compared to those with plaque rupture. Specific clinical and laboratory predictors were validated to suspect PE among acute coronary syndrome (ACS) patients. Purpose The objectives of this study were to compare both clinical and laboratory findings, and outcomes of ACS patients with high probability of PE and those with less likely PE. Methods Six hundred ninety-six ACS patients were divided into two groups (suspected PE vs less likely PE) based on 5 reported predictors of PE. The predictors were: age <68, anterior ischemia, no diabetes mellitus, hemoglobin >15 g/dL and normal renal function (eGFR> 60 ml/min) as assessed at hospital admission. Patients with 4 or 5 of these 5 predictors were included in the suspected PE group, while patients with 0 or 1 entered less likely PE group. Baseline clinical features and laboratory analyses at hospital admission were compared between the two groups. Major adverse cardiac events (MACE), defined as death from any cause, non-fatal myocardial infarction or unplanned revascularization, were compared between the two groups at 20 months after hospital discharge. Results Among 696 patients, 283 (41%) composed the suspected PE group, while 413 (59%) entered into less likely PE group. The suspected PE group had a higher prevalence of current smokers and had a higher BMI. They showed higher values of both LDL cholesterol and triglycerides, while C-reactive protein and fibrinogen levels were significantly lower. The suspected PE group showed a higher frequency of single vessel disease (Table). The suspected PE group showed a significantly lower rate of MACEs at 20 months (7.4% vs 28.8%, p=0.0001) as well as death from any cause was significantly lower (2.1% vs 24.9%, p=0.0001). The median time from the index ACS episode to recurrent myocardial infarction or unplanned coronary revascularization tended to be longer in the suspected PE group as compared to the less likely PE group (15 months [9-20] vs 9 months [6-13], p=0.062) (Figure). Conclusions In a cohort of ACS population, the suspected PE group showed distinctive clinical characteristics with less coronary plaque burden and low grade of systemic inflammation. The suspected PE group had a better prognosis at 20-month follow-up time with a significantly lower rate of death from any cause, and non-fatal coronary events tended to occur later.Table.Baseline characteristicsFigure.Non fatal coronary events

Evaluation of protein extraction protocols for MALDI-TOF Biotyper analysis of mycobacteria

Infections caused by Mycobacterium tuberculosis and nontuberculous mycobacteria represent a significant global threat and medical concern. Therefore, accurate and reliable methods must be employed to identify mycobacteria rapidly. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is a technique that compares the cellular protein profiles of unknown isolates with reference mass spectra in a database to identify microorganisms. However, the thick and waxy lipid layer, which is rich in mycolic acids and is present in mycobacterial cells, makes protein extraction challenging. To identify the optimal protocol for correctly identifying bacilli using MALDI-TOF mass spectrometry, this study compared four different cellular protein extraction methods. Four strains of M. bovis BCG were selected as representatives of slow-growing mycobacteria, while three strains of fast-growing mycobacteria were also included: M. peregrinum, M. smegmatis, and M. farcinogenes. The extraction method that proved most effective was the extraction of inactivated cells with chloroform and methanol, which partially delipidates the cells. These cells were then extracted with formic acid, as is standard practice for protein extraction. The advantage of this method is that it allows the parallel analysis of cellular lipids and proteins from a single sample. It is therefore important to optimize mycobacterial protein extraction for MALDI-TOF MS analysis in clinical microbiology laboratories.

A-260 Mapping pediatric urinary tract infections: trends, prevalence and sensitivity to antimicrobials

Abstract Background Urinary tract infections (UTIs) rank among the most prevalent bacterial infections in pediatric populations, with neonates being particularly susceptible. Moreover, UTIs have a propensity for recurrence, posing ongoing health challenges. Prompt diagnosis of pediatric UTIs is crucial for timely and effective treatment, averting potential long-term complications. While clinical signs often suggest UTI diagnosis, additional tests like urinalysis and urine culture are vital to identify the causative pathogen and its antibiotic sensitivity. This study aims to quantify microorganism prevalence in positive pediatric urine tests and assess their antimicrobial resistance profiles. The purpose is, therefore, to offer scientific basis so that there is greater agility in establishing the diagnosis of UTIs in children and indicating the best antibiotic to be used empirically to prevent late consequences. Methods Between January and December 2019, a cross-sectional study was carried out with urine samples from children and adolescents collected in the database of the Clinical Analysis Laboratory of Cuiabá - MT in 2019. Only records of samples collected in the study were included in the study. laboratory of patients of both sexes, age range 1 month to 15 years. Bacterial analyzes were classified according to Gram positive, Gram negative (glucose fermenters or non-fermenters) and the sensitivity profile was standardized according to the Clinical and Laboratory Standards Institute (2019). The data were subjected to descriptive statistical analysis. Results Of the 532 positive urine samples from pediatric patients, enterobacteria were responsible for 435 (81.76%) with E. coli (64.1%) and Proteus mirabilis (15.8%) being the most isolated bacteria, in relation to Gram-positive bacteria 64 (12.03%) main bacteria was Enterococcus faecalis (81.2%) and non-glucose fermenters for 33 (6.2%) corresponding to Pseudomonas aeruginosa. E. coli, with 279 cases, was the most frequently isolated microorganism, representing (64.1%) of the cases. Females were the most affected, in 83.5% there was growth of Enterobacteria, in the Pseudomonas aeruginosa group, 51.5% of cases were female. and in Gram+ girls represented 56.2%. In those tested only for E. coli, the highest sensitivity was observed in fosfomycin (97.82%). Enterobacteriaceae showed high susceptibility to meropenem (99.8%), ertapenem (99.8%), ceftriaxone (93.8%), and ceftazidime (93.6%), but exhibited considerable resistance to sulfamethoxazole/trimethoprim (35.5%), amoxicillin (33.4%) and ampicillin (29.2%). Pseudomonas aeruginosa and gram positive bacteria were sensitive to all antibiotics tested. Conclusions The data indicate that E. coli continues to be the predominant agent in pediatric UTIs, particularly affecting females and the very young age group < 3 years. Regarding sensitivity profiles, bacteria were more sensitive to carbapenems and aminoglycosides. Early diagnosis is crucial to preventing long-term complications associated with UTIs in children. Consequently, this research provides a scientific basis for faster UTI diagnosis and empirical antibiotic selection in pediatrics, which may prevent late adverse outcomes.

Lamellar Body Count (LBC) in amniotic fluid for prediction of fetal lung maturity

Background: Neonatal respiratory distress syndrome (RDS) is a disorder due to pulmonary immaturity with a high mortality characterized by low levels of pulmonary surfactant. RDS is one of the important causes of mortality in neonates. Objective: The aim of the study is to determine the lamellar body count (LBC) cutoff value for foetal lung maturity and to evaluate the clinical usefulness of LBC in predicting the neonatal respiratory distress syndrome (RDS) and to find if the Measurement of LBC can replace the conventional Lecithin/Sphingomyelin ratio. Methods: This prospective observational study was performed on total 47 pregnant women divided as 19 patients with premature labor and 28 patients with healthy full-term singleton pregnancy as controls, with gestational age between 28 – 41 weeks at Ain Shams university maternity hospital in period between April 2014 and January 2015 with inclusion and exclusion criteria. Results: RDS was diagnosed in 20 neonates, two neonates in the 1st group (7.1%) While 18 neonates in 2nd (94.7%) showed development of RDS. Mean lamellar body count in newborns with RDS: 39,200 ± 12,438 with median 37,500 and p-value was <0.0001. ROC (receiver operator characteristics) curve showed that by using 51000/µL as a cut-off point for LBC it is a good predictor for fetal lung maturity with sensitivity 95% and specificity 96.3%. There is a direct relationship between the gestational age and the lamellar body count as the lamellar body count increases as long as the gestational age proceeds with a highly significant positive correlation (p value <0.0001). Conclusion: As evident from the current study, LBC count now replacing the conventional Lecithin/Sphingomyelin ratio because the test can be performed with equipment found in most clinical analysis laboratories and is reliable in predicting foetal lung maturity. This study suggests that LBC cutoff value of ≥51,000/µL can predict pulmonary maturity and reduce the risk of neonatal respiratory distress syndrome.

Frecuencia y conocimiento de tripanosomiasis americana en habitantes de la municipalidad de Vinto, Cochabamba, Bolivia

Introduction: American trypanosomiasis is caused by the blood parasite Trypanosoma cruzi, it affects 21 countries in the America, especially rural populations. Objectives: To determine the frequency and knowledge of American trypanosomiasis, as well as to disaggregate the frequency of American trypanosomiasis reemplazar por by sex and age group in the inhabitants of the municipality of Vinto, Cochabamba - Bolivia. Materials and Methods: A descriptive study with a non-experimental cross-sectional design was carried out. A total of 207 inhabitants of the municipality of Vinto attended the clinical analysis laboratory of the Biochemistry Department of the Adventist University of Bolivia. The sera were processed by indirect hemagglutination (HAI). Knowledge about American trypanosomiasis was determined by means of a structured survey. Pearson’s chi-square was used to relate variables and was considered significant at p<0.05. Results: The frequency of American trypanosomiasis in inhabitants of the municipality of Vinto was 11.6%. There was no relationship between the frequency of American trypanosomiasis and sex (p>0.05) but there was a relationship with the age group (p<0.05). 72.9% claimed to know about American trypanosomiasis. Conclusions: The results show that the frequency of American trypanosomiasis is low and that most of the inhabitants of the municipality of Vinto, Cochabamba, Bolivia have knowledge about the disease. In addition, it was found that there is only a relationship betweenthe frequency of American trypanosomiasis and age group.

Profile of Laboratories With the Seal of the Clinical Laboratory Accreditation Program (PALC)

Objective: The objective of this study is to analyze clinical analysis laboratories accredited by the quality seal of the Clinical Laboratory Accreditation Program (PALC) in Brazil. Theoretical Framework: It presents the fundamentals of the research, covering the importance of hospital accreditation, PALC regulations, historical evolution of hospital quality, economic impact on health, quality management in clinical laboratories and the usefulness of quality indicators. Method: A documentary study was carried out, with descriptive and quantitative analysis. During the study period, 163 clinical laboratories were detected in the country accredited by the PALC seal. Results and Discussion: In the study, 163 accredited clinical laboratories were identified in Brazil, with only 32 laboratories in the entire northeast region. Where 92% of accredited laboratories are private and 82% are part of large national diagnostic networks. Highlighting the need for greater investment in quality seals, which better certify the quality of the laboratory service provided. Research Implications: The importance of policies and strategies to promote the accreditation of clinical laboratories stands out, especially in the northeast region of Brazil, aiming to improve the quality and reliability of health services provided to the population, in addition to promoting greater security in medical diagnoses. Originality/Value: This study contributes to the literature by highlighting the originality by examining the grographic distribution and the public and private nature of accredited clinical laboratories in Brazil. The relevance and value of this research are evidenced by its crucial role of accreditation in ensuring quality laboratory services, encouraging continuous improvement and patient confidence.

Prolonged detection of BPV2 in urine and blood of papillomatosis-affected cattle not grazing bracken fern.

BPV-2 infection can cause bladder infections in cattle that, when associated with bracken fern consumption, can progress to cancerous bladder tumors and also present as bovine enzootic hematuria (BEH). This study aimed to evaluate the prolonged natural BPV-2 infection in the blood and urine of cattle, excluding bracken fern consumption. Thirteen Girolando papillomatosis-affected cattle with no bracken fern contact history were monitored for 20 months. Blood, urine, and wart samples were collected for BPV-2 detection and clinical laboratory analyses. All animals showed the presence of BPV-2 in papillomas and blood, and 92.85% showed BPV-2 in urine, suggesting viral dissemination in the urinary tract. Despite all animals being infected with BPV-2, none showed BEH signs during the study. Thus, it was observed that BPV-2 infection alone didn't induce BEH over 20 months, implying a complex interaction with environmental factors or genetic predisposition. This underlines bracken fern consumption's critical role in urinary bladder carcinogenesis. The study underscores BEH's pathogenesis complexity, advocating longitudinal studies to comprehend BPV-2's role fully.

Nutritional and gastrointestinal manifestations in Rett syndrome: long-term follow-up.

Rett syndrome is a rare neurodevelopmental disorder associated with methyl CpG binding protein 2 (MECP2) gene mutations. We aimed to characterize the long-term nutritional and gastrointestinal course of Rett syndrome in a large national patient population. We conducted a retrospective cohort study of patients followed during 1991-2021 at a national center for Rett syndrome. The data retrieved included clinical features, laboratory and genetic analyses. Continuous anthropometric measurements were calculated for the closest visit to the median ages: 2.5, 7.5, 12.5 and 17.5 years. Kaplan Meier curves were used to describe the appearance of clinical manifestations during the follow up period. Generalized estimating equation models were used to compare repeated measurements. Included were 141 patients (139 females), the median age at the first visit was 3.2 years (interquartile range [IQR] 2.3-5.7), and the median length of follow-up was 94.5 months (IQR 28.6-153.3). Mean weight, height and BMI Z-scores were -1.09, -1.03 and -0.56, respectively, at median age 2.5 years; and deteriorated to -3.95, -3.01 and -1.19, respectively, at median age 17.5 years (P < 0.001). Gastrointestinal features included constipation (47.5%, 67/141) and chewing/feeding difficulties (20%, 28/141) at presentation; and an additional 47 (33.3%) and 24 (17.0%), respectively, during follow up. Twenty-eight patients (20%) developed aerophagia and 44 (31.2%) gastroesophageal reflux. No relation was found between genetic mutation types and clinical manifestations. GI manifestations were more prevalent in patients with typical form of Rett syndrome. Anthropometric parameters were shown to deteriorate with age, regardless of the specific genetic mutation. Chewing/feeding difficulties, constipation and gastroesophageal reflux are common in Rett patients.

Value of Platelet-to-Lymphocyte Ratio in Acute Coronary Syndrome for Predicting In-Hospital Complications and Mortality

Background: Acute coronary syndrome (ACS) refers to a spectrum of urgent heart conditions caused by a sudden decrease in blood flow to the heart. This condition demands immediate medical attention as it can lead to severe complications, including heart attack and death. The platelet-to-lymphocyte ratio (PLR) has recently gained attention as a potential biomarker for assessing the inflammatory status in ACS patients. Inflammation plays a crucial role in the pathophysiology of ACS, and biomarkers like PLR can offer insights into the severity and prognosis of the disease. Methods: This study was a prospective cross-sectional analysis conducted in Sulaymaniyah city, spanning from December 2021 to December 2022. The study included 100 patients who were diagnosed with ACS and subsequently hospitalized. Data collection involved comprehensive clinical histories, physical examinations, and laboratory analyses. Among the laboratory tests, complete blood counts were performed to calculate the PLR for each patient. Based on their PLR levels, patients were categorized into two primary groups for comparative analysis. Results: In a study of 100 ACS patients (mean age 61.54 years, 69% male), elevated PLR correlated with lower oxygen saturation, more frequent STE-ACS (70.6%), and higher in-hospital complications, including mortality (11.8%). No significant links were found between PLR and traditional CAD risk factors. Conclusion: The findings of this study underscore the potential prognostic value of PLR in ACS patients. Elevated PLR was significantly associated with worse oxygen saturation, a higher prevalence of STE-ACS, and an increased occurrence of in-hospital complications and mortality.

Cultura tributaria y cumplimiento de obligaciones tributarias en los laboratorios de análisis clínico de Cajamarca

The main purpose of the study was to determine the relationship between tax culture and compliance with tax obligations in the clinical analysis laboratories of Jaen. As indicated, the use of the applied methodology was necessary, with the non-experimental design being cross-sectional. was also correlational in scope, along the same lines, the population and sample were made up of 36 collaborators from the laboratories analyzed. Regarding the research technique, the survey was used and the questionnaire was used as the research instrument. The results indicate a significance of 0.005 and a Rho value: 0.461. It is concluded that the variables tax culture and compliance with tax obligations are correlated.

Neurological Effects of Stimulants and Hallucinogens.

In this article, we will discuss the history, pharmacodynamics, and neurotoxicity of psychostimulants and hallucinogens. The drugs discussed are widely used and have characteristic toxidromes and potential for neurological injuries with which the practicing clinician should be familiar. Psychostimulants are a class of drugs that includes cocaine, methamphetamine/amphetamines, and cathinones, among others, which produce a crescendoing euphoric high. Seizures, ischemic and hemorrhagic strokes, rhabdomyolysis, and a variety of movement disorders are commonly encountered in this class. Hallucinogens encompass a broad class of drugs, in which the user experiences hallucinations, altered sensorium, distorted perception, and cognitive dysfunction. The experience can be unpredictable and dysphoric, creating a profound sense of anxiety and panic in some cases. Recognizing the associated neurotoxicities and understanding the appropriate management is critical in caring for these patient populations. Several of these agents are not detectable by standard clinical laboratory analysis, making identification and diagnosis an even greater challenge.

Study of the effect of anemia on lipid levels in some patients in the city of Mosul

Many scientific studies indicated that there is no close correlation between the malnutrition and weight gain (obesity) with iron deficiency, which leads to anemia. This study was designed to find the nature of the relationship between fat accumulations in adults with anemia.This study and tests were conducted in Mosul/Iraq, and random samples werecollected from adults in two clinical analysis laboratories accredited by the Department of Health. The samples were taken after fasting for 14 consecutive hours to check out the level of cholesterol, LDL, the lipase enzyme, and some chemical elements such as iron and copper, as well as measuring the HB% percentage. The results were analyzed statistically based on the t-test using SPSS statistical program, and a value of p&amp;#60;0.05 was considered a significant value within the results.The ages of the people targeted in this investigation were between (18-50) years, and after collecting the test results and analyzing them statistically, the samples were divided into three groups based on the severity of iron deficiency (anemia).The people included in the first group (group A) were with severe anemia, while people in the second group (group B) were for moderate to weak anemia, whereas the third group (group C) designed to be a control group (people who do not have anemia). A comparison was made between group A with the control group C, and the average cholesterolconcentration in group A appeared to be higher than that in group C,-With a significant difference, while the average lipase and LDL levels were slightly, higher in group A compared to the control group, but it was not significant. As for the chemical elements, the average Fe in group A was low, with a significant difference at p&amp;#60;0.05 compared with C, while the copper element, was low in the first group compared to the third group, but it was not significant. The average hemoglobin (Hb) concentration was different between the three mentioned groups, and it was low in the first group compared to the second and third group. There were a significant changes in Hb concentrations between group A compared to group C, while there was no significant difference between group B and group C.The results of the study, after comparing the groups, showed a significant increase in cholesterol concentration in people with all groups of anemia and non-significant differences based on statistical significances in the concentration of lipase and low-density lipoprotein in people with anemia compared to the control group. As in copper element, it was non-significantly low in people with anemia, in contrast, the concentration of iron was low and significant in those with anemia, which is the significant cause of anemia in adults. The study results may agree with previous studies and/ or different from other studies. Therefore, it is suggested that more experiments and research have to be done to find the physiological causes for the extent of the effects of anemia on fat concentrations.

Effluents from a university clinical analysis teaching laboratory: an inductive study on adhesion and cellular response of Pseudomonas aeruginosa

Microbial resistance to antibiotics is a global threat and the World Health Organization (WHO) predicts that future pandemics will involve resistant microorganisms. Recently, the WHO published a list of pathogenic microbes whose priority level varies among medium, high and critical. All bacteria in the list can form biofilms. Biofilms are structures made of polymeric adhesive matrix composed by multispecies in close association. Additionally, biofilm provides an important physical barrier. Different phenotypes are found in biofilms, ensuring resistance to oxidative stress, as well as environmental stress factors. It results cell persistence because there is generation of a gradient of chemical inhibitors at subinhibitory levels, which promote the development of resistant subpopulations able to grow and disseminate. Clinical analysis laboratories are sources of selective pressures for potentially pathogenic bacteria because different substances are handled and discarded daily by the effluents generated. This study assessed the activity of a highly toxic leachate on isolates of Pseudomonas aeruginosa recovered from the sinks of a university clinical analysis teaching laboratory. In vitro biofilm formation tests, pyocyanin quantification, cell wall hydrophobicity test, motility test and susceptibility to seven antibiotics were carried out. The isolate with the most antibiotic resistance was assessed. There was a reduction in adhesion of 14 to 430%. Biofilm was formed, however, on all tested materials; the cells preferentially adhered to hydrophilic surfaces, dolomite, followed by galvanized iron and glass. Maximum pyocyanin production was 12 mM. Swimming motility was stimulated, recording a 12-fold increase in speed, while swarming and twitching motility were inhibited by around 20 and 60%, respectively. All isolates were resistant to cephalosporins and one isolate was detected resistant also to ciprofloxacin. The results indicated that P. aeruginosa survived the leachate, triggering different adaptive physiological responses to persist in the stressful environment.

Methodology for the determining aromatic monocarboxylic acids as products of phenylalanine and tyrosine metabolism: current advances and trends

A review on the quantitative determination of aromatic monocarboxylic acids (AMCAs), intermediates in the metabolism of the proteinogenic amino acids phenylalanine and tyrosine, in body fluids is presented. The importance of these compounds as potential diagnostic low-molecular-weight biomarkers of some human diseases is described. The main methodical features of current practical solutions in the field of highly sensitive screening of AMCAs in body fluids using chromatography-mass spectrometry and other methods actively used in clinical laboratory analysis are considered. Special attention is paid to the prospects of developing portable tools for therapeutic monitoring of the compounds of interest in biological fluids. &lt;br&gt; The bibliography includes 108 references.

Changes in blood biochemical parameters in highly productive cows with ketosis.

Biochemical blood testing is the main diagnostic indicator of the clinical condition of highly productive animals and a method of determining changes in metabolic disorders. This study focuses on metabolic changes (ketosis), which are of the utmost importance in the assessment of the health status of animals, as well as differences in intergroup characteristics. The main focus of this study is to demonstrate the influence of subclinical ketosis in highly productive cows on changes in biochemical blood parameters during different physiological periods to further prevent this disease, adjust feeding rations, and prevent premature culling of animals. This study aimed to evaluate and establish changes in the biochemical status dynamics of highly productive cows with metabolic disorders in an industrial livestock complex. Blood samples were systematically collected from highly productive cows of the Simmental breed (n = 60) and served as the primary material for subsequent analyses. Each methodological step was designed to ensure evaluation of the metabolic changes associated with post-calving adjustments in highly productive dairy cows. This study employed a comprehensive approach integrating clinical assessments, laboratory analyses, biochemical evaluations, instrumental measurements, and statistical analyses. A biochemical blood test showed that the number of ketone bodies in the experimental group exceeded the norm, varied depending on the physiological state of the animals, and ranged from 0.89 to 1.45 mmol/L. At 10 days after calving, the highest indicator was 1.45 ± 0.05 mmol/L. This indicator was 1.05 mmol/L higher than that in the control group and exceeded the norm by 0.95. Excess ketone bodies in the blood of animals led to accumulation in urine and milk, indicating a disturbance in metabolic processes in the body and a decrease in the quality of animal husbandry products. The sample size and the focus on a single breed from one geographical location may limit the generalizability of the findings. Further research should explore the mechanistic bases of ketosis development, potentially integrating genomic and proteomic approaches to understand the genetic predispositions and molecular pathways involved.

Acute watery diarrhoea cases during cholera outbreak in Syria: a cohort study

ObjectivesThe aim of this study is a descriptive presentation of cases of acute watery diarrhoea (AWD) that were presented to Aleppo University Hospital (AUH) during the recent cholera outbreak in...

Cardiac Magnetic Resonance Imaging as a Risk Stratification Tool in COVID-19 Myocarditis.

The aim of this retrospective study was to identify myocardial injury after COVID-19 inflammation and explore whether myocardial damage could be a possible cause of the persistent symptoms following COVID-19 infection in previously healthy individuals. This study included 139 patients who were enrolled between January and June 2021, with a mean age of 46.7 ± 15.2 years, of whom 68 were men and 71 were women without known cardiac or pulmonary diseases. All patients underwent clinical work-up, laboratory analysis, cardiac ultrasound, and CMR on a 1.5 T scanner using a recommended protocol for morphological and functional assessment before and after contrast media application with multi-parametric sequences. In 39% of patients, late gadolinium enhancement (LGE) was found as a sign of myocarditis. Fibrinogen was statistically significantly higher in patients with LGE than in those without LGE (4.3 ± 0.23 vs. 3.2 ± 0.14 g/L, p < 0.05, respectively), as well as D-dimer (1.8 ± 0.3 vs. 0.8 ± 0.1 mg/L FEU). Also, troponin was statistically significantly higher in patients with myocardial LGE (13.1 ± 0.4 ng/L) compared to those with normal myocardium (4.9 ± 0.3 ng/L, p < 0.001). We demonstrated chest pain, fatigue, and elevated troponin to be independent predictors for LGE. Septal LGE was shown to be a predictor for arrhythmias. The use of CMR is a potential risk stratification tool in evaluating outcomes following COVID-19 myocarditis.

The Lipid-Lowering Efficacy of a Nutraceutical Combination Including Leucoselect Phytosome, Red Yeast Rice, Policosanol and Folic Acid in Dyslipidaemia Patients: Real-World Insights.

Cardiovascular disease is a global health concern and reducing plasma LDL-C levels is a major goal in cardiovascular prevention. Our study aimed to evaluate the effectiveness of a nutraceutical formulation including leucoselect® phytosome®, red yeast rice, policosanol and folic acid on LDL-c levels in patients at low cardiovascular risk with dyslipidemia. We prospectively enrolled all consecutive patients with dyslipidemia at low cardiovascular risk who were unresponsive to diet and physical activity. Clinical assessments and laboratory analyses, encompassing lipid profile, hepatic function, and CPK levels, were performed at baseline prior to initiating treatment and repeated at the 12-week mark following administration of the study nutraceutical. Sixty (60) consecutive patients (mean age 48.02 ± 10.1 years; 60% male) were included. At the 12-week follow-up, a statistically significant reduction in Total Cholesterol (13.1%) and LDL-c serum level (20.4%) was observed. Hepatic and muscular function remain stable over the time. The adherence to therapy was 99% and the persistence was maximum. The nutraceutical formulation including leucoselect® phytosome® red yeast rice, policosanol and folic acid significantly reduced the LDL-c plasma levels, consistent with previous research showing that the bioactive component in red yeast rice-lovastatin-is effective in addressing problems with lipid metabolism. Importantly, it was safe and well-tolerated among patients with dyslipidemia in a real-world setting.